Hospitals Take Flight Lessons from Pilots to Avoid Government Penalties

Collierville TN (PRWEB) May 05 2013 In 2013 government regulators will penalize 1427 U.S. hospitals because too many of their patients are re-admitted to the hospital for follow-on care. The New York Tmes reports that Medicare which monitors hospitals’ compliance wi

In 2013, government regulators will penalize 1,427 U.S. hospitals because too many of their patients are re-admitted to the hospital for follow-on care. The New York Tmes reports that Medicare, which monitors hospitals’ compliance with the new rules, says nearly two-thirds of hospitals receiving traditional Medicare payments are expected to pay penalties totaling about $300 million in 2013 because too many of their patients were readmitted within 30 days of discharge. For hospitals with lots of Medicare patients, hundreds of thousands of dollars are at stake, money that could be spent on safety and quality. In all, the Medicare penalties tie almost $1 billion in payments to hospitals to the quality of care provided to patients as measured by readmission rates.

To avoid these penalties, hospitals are taking lessons from aviation on how to improve doctor-patient communications to prevent mistakes leading to unnecessary readmissions.

Beyond the penalties imposed by Medicare, hospitals waste almost $73 billion a year simply because patients do not understand what physicians and nurses are saying to them. Hospitals believe that if these communication breakdowns could be fixed, it would dramatically improve readmission problems. Health care facilities are turning to LifeWings, an aviation–based patient safety training company, to teach their physicians and nurses to stop these communication errors.

The LifeWings training is based on 7 low cost, or no cost, simple things that can be done to improve readmission issues:

1. Take responsibility for the patients' health literacy. This is a small change in thinking with huge implications for safety. Most hospitals approach the problem as if it were solely the patients’ responsibility to make themselves smart about their care. Physicians and medical teams need to communicate on the patient's level, or to make sure the patient understands what they have just been told. A question LifeWings proposes is “What would you do differently if you assumed the patient knew nothing about healthcare and it was totally your responsibility as the healthcare provider TO MEET THEM WHERE THEY ARE – NOT WHERE YOU WISH THEY WERE in terms of health literacy?” It is the experts (doctor’s) responsibility to make sure the listener (the patient) understands. If patients cannot understand the plan of treatment, they won't follow through properly, and hospitals will have more readmissions, thus less money for safe, high quality care.

2. Write all instructions about the plan of care and medications at the 5th grade level. Analysis of health care literature for patients reveals that almost all of it is written at the eleventh grade level. The truth is that 93 million Americans read between the third and fifth grade level. Thirty-four percent have low literacy when it comes to reading forms or documents. An astonishing 55% have low literacy when it comes to numbers.

3. Use 14-point type or larger. Most health care instructions are written in 10-point type. This is too small for most patients and they don't even try to read it.

4. Use plain English words and avoid medical jargon. Use terms like earache not “otitis media”. Use language you would use among friends and family. Use directions a 12 year old could understand when giving out discharge instructions.

5. Always tell your patients "Why." Offer an explanation to the patient and explain exactly why this medication will help them have a longer and healthier life. Have a strong dialogue that draws patients into the cause of better health and this will get better compliance.

6. Get a "read-back" from your patients. Explain the discharge instructions to the patient. Have them repeat back in their words what you told them. Go back and forth until you are confident the patient understands. This takes extra time but less time than a re-admit. Limit the discharge instructions to three "need to know" messages.

7. Use the phrase, "What questions do you have?" Don't ask, "Do you have any questions," as patients are likely to simply say "no," even if they don't understand. This is a technique used by professional pilots in the cockpit after their crew briefing. LifeWings also teaches surgeons to use this question after their WHO Safe Surgery Checklist briefing. They have discovered that using the phrase, "What questions do you have?" always generates more questions and discussion than "Do you have any questions?"

Steve Harden, Chairman and CEO of LifeWings, explains why hospitals are not doing these things already, “Health care staff are very well educated. Many of them think that writing at a lower grade reading level or using plain language is ‘dumbing down,’ and that using plain language that is easy to read is unprofessional and insulting. Actually, writing simply and clearly is very difficult.” Harden goes on to say, “Many healthcare professionals have the mistaken belief there is no need to do these things. They think that most patients understand what they’re saying to them or their patients would be asking more questions. In reality, patients often just nod their heads because they don’t want to appear uneducated.”

Harden says that training to use these seven steps will bust the myths and help hospitals provide safer, higher quality care to patients, while protecting the hospital's bottom line.

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